Disturbing Conscience into Action

on the controversial book 'Sans Everything', the publication of which has sparked off a ministerial enquiry. Sans Everything is a frightening book. A collection of case histories of the elderly and mentally disturbed, it tells of inefficiency, unkindness, disrespect and neglect in geriatric wards. The cases are probably exceptional but, however rare the instances may be, it is essential that the public and official conscience should be disturbed into action. Whatever enquiries are made into individual complaints , the whole of our thinking about the care of the mentally infirm needs to change. To begin with there is a lack of identification of actual mental difficulty?the apparently senile may be deteriorating because their glasses need changing or they want a hearing-aid. There is also an awful, unmeasured infectiousness I about senility?the rapid deterioration, the diminishing of personality, the acceptance of incontinence of the institutionalized. We know that many old people are in mental hospitals just because there is nowhere else for them to go. But what are we doing about it? AEGIS (Aid for the Elderly in Government Institutions) makes some suggestions in this book. Its scheme to build small townships in the large grounds of certain hospitals is particularly attractive. Normal family ; flats and houses could provide revenue to finance new accommodation for the sick elderly?that is for genuinely geriatric cases, while psychiatric cases would be concentrated in other hospitals outside the scheme. I think that, apart from investigating specific complaints , we need to know more about the effects on staff of long periods of hard work, often residential in institutions a long way from anywhere. Are there some personalities which do not survive unimpaired? I have by me a very moving letter from a middle-aged Woman trying to keep her mother of nearly 90 at home. 'I am constantly disturbed by the loss of affection I feel towards my mother, of whom I have always been very fond, and have to be eternally on my guard so as not to give way to anger or irritation or grumbling. Each night as I go to bed, but rarely to sleep, I have to pray for pardon for my many shortcomings.